Sodium channelopathy induced by mild axonal trauma worsens outcome after a repeat injury

Authors

  • Tracy J. Yuen,

    1. Center for Brain Injury and Repair, University of Pennsylvania, Philadelphia, Pennsylvania
    2. Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania
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  • Kevin D. Browne,

    1. Center for Brain Injury and Repair, University of Pennsylvania, Philadelphia, Pennsylvania
    2. Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania
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  • Akira Iwata,

    1. Nagakute Minami Clinic, Aich-gun, Aich, Japan
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  • Douglas H. Smith

    Corresponding author
    1. Center for Brain Injury and Repair, University of Pennsylvania, Philadelphia, Pennsylvania
    2. Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania
    • 3320 Smith Walk, 105 Hayden Hall, University of Pennsylvania, Philadelphia, PA 19104-6316
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Abstract

There is great concern that one mild traumatic brain injury (mTBI) predisposes individuals to an exacerbated response with a subsequent mTBI. Although no mechanism has been identified, mounting evidence suggests traumatic axonal injury (TAI) plays a role in this process. By using a cell culture system, a threshold of mild TAI was found where dynamic stretch of cortical axons at strains lower than 5% induced no overt pathological changes. However, the axons were found to display an increased expression of sodium channels (NaChs) by 24 hr. After a second, identical mild injury, pathologic increases in [Ca2+]i were observed, leading to axon degeneration. The central role of NaChs in this response was demonstrated by blocking NaChs with tetrodotoxin prior to the second injury, which completely abolished postinjury increases in [Ca2+]i. These data suggest that mild TAI induces a form of sodium channelopathy on axons that greatly exaggerates the pathophysiologic response to subsequent mild injuries. © 2009 Wiley-Liss, Inc.

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